March 30th, 2023

Service Delivery Logs for Individualized Skills and Socialization

As of March 14th, 2023, information from the HHSC ISS SDL website page:

Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, and Form 8616, In-Home Individualized Skills and Socialization Service Delivery Log, are no longer mandatory to document a service claim of on-site, off-site, or in-home individualized skills and socialization.

A program provider may develop their own service delivery logs or use an electronic health record system to document individualized skills and socialization. All elements from Form 8615 and Form 8616 must be included in any documentation developed.

For each service event the service delivery log must include the following elements:

Individual’s name
Name of the individualized skills and socialization provider
Individualized skills and socialization Provider License Number
Date of service
Time in and time out for each service event
Location
Description of billable activities
Name and signature of service provider

For off-site service delivery logs, in addition to the information above for each service event, the elements that must be documented include:

Individual’s level of need (LON)
Ratio or approved enhanced staff rate
Number of individuals being served by the service provider during the service event
Name and address of community location(s) visited during the off-site service event
Name and signature of the service provider

For in-home service delivery logs, in addition to the information for each service event, the elements that must be documented include:

Staff ID as assigned by the program provider (meaning the HCS/TxHmL program provider)

HHSC will update Form 8615 and Form 8616 to provide Spanish-language versions. Any submission of forms containing information that is not in English will need to comply with 26 TAC §263.7.

For providers who use Form 8615 and Form 8616, HHSC has provided clarification below:

Form 8616 and Form 8615 are only required to document service events for individuals in the HCS and TxHmL Programs. (Does not include DBMD program)

In the off-site section of the form:

“Ratio” refers to the ratio for the individual as required by 26 TAC §263.2017 (HCS) or 26 TAC §262.917 (TxHmL).
“Staff” would equal one.
“Individuals” refers to the total number of individuals or other persons receiving services assigned to a service provider during a service event. This does not include any identifying information. *Persons outside of the HCS and TxHmL Programs, receiving a similar service, must be included in the number of individuals for the delivery of off-site individualized skills and socialization.

Form 8615 and Form 8616 were developed to document a service event for on-site, off-site, or in-home individualized skills and socialization. Program providers may request additional information or documentation from an individualized skills and socialization provider to obtain updates on the progress or lack of progress towards an individual’s goals.

The days of the week included on Form 8615 and Form 8616 may be altered if an individual receives individualized skills and socialization on a Sunday or Saturday. The program provider must ensure that an individual does not exceed the service limit of five days per calendar week (Sunday–Saturday).

Each service event must have an exact time in and time out and all documented elements. The total amount of time providing the service each day cannot be combined into one service event for that date.

If a program provider chooses to complete Form 8615 or Form 8616 electronically, it must be in compliance with 40 TAC §49.305(j) related to a contractor using electronic records.

For questions about this alert or the service delivery logs for individualized skills and socialization, email HCSPolicy@hhs.texas.gov.

March 1st, 2023

ISS Service Delivery Logs (SDL’s) & Electronic Health Record (EHR) systems

Do providers have to use HHSC Forms 8615 and 8616 – ISS Service Delivery Logs for On-Site and Off-Site ISS and In-Home ISS?

Can they use their own forms or EHR systems?

HHSC Response: HCS Policy is working to develop clarification on the service delivery logs forms. Further communication will be provided and the HCS Billing Requirements will be updated to reflect that a program provider may use the forms provided by HHSC or they may use their own forms or EHR systems that include all required elements.

February 21st, 2023

Service Delivery Logs Finally Available for Individualized Socialization Skills Services

Form 8616 – In-Home ISS: https://www.hhs.texas.gov/regulations/forms/8000-8999/form-8616-home-individualized-skills-socialization-service-delivery-log

Form 8615 – On & Off-Site ISS: https://www.hhs.texas.gov/regulations/forms/8000-8999/form-8615-site-site-individualized-skills-socialization-service-delivery-log

**Please Note: In viewing please know that the logs only include Monday – Friday. According to HHSC the form will not be changed, rather one can just scratch out one of the days listed and write Saturday or Sunday on it. Also, the form to document On- and Off-site ISS does not provide instructions on what to enter into the fields labeled “Staff’ and Ratio”.

External workgroup members commented that many providers use Electronic Health Records (EHRs), thus asking if HHSC would remove the requirement that the provider must use the ISS service log created by HHSC. HHSC has so far stated that they will consider and get back about this issue. For now you may have to upload completed forms to your EHR system if possible for billing purposes. Some EHR systems are creating the same form I believe in their program.

If you are having problems with how to fill out the forms, please scroll down the same page you find the link to click on to open the original document. Here are the instructions for the 8615 form

INSTRUCTIONS: Updated: 2/2023

Purpose

Form 8615 is used by Texas Health and Human Services Commission (HHSC) staff, as well as Home and Community-based Services (HCS) and Texas Home Living Service (TxHmL) Waiver program providers to document a service event for on-site and off-site individualized skills and socialization.

Procedure

When to Prepare

Form 8615 must be completed within 14 calendar days after the activity being documented is provided.

Form Retention

The program provider must maintain a copy of the completed Form 8615 in the individual’s record.

General Instructions

Form 8615 must be used for only one individual.
Form 8615 may be used for multiple billable service events. Each billable service event must have a begin and end time.
Form 8615 is considered a Medicaid document used for Medicaid purposes. By using this form, you understand it is your responsibility to record accurate information, as this information may be subject to a court of law. Failure to record accurate information or deliberate falsification of documentation is strictly prohibited.

Detailed Instructions

Individual Name — Enter the individual’s name.

Place of Service(s) — Enter the address at which the billable activity occurred.

Level of Need — Enter the individual’s level of need.

Name of Individualized Skills and Socialization Provider — Enter the name of the entity.

Individualized Skills and Socialization Provider License Number — Enter the license number of the individualized skills and socialization provider.

Date and Days of the Week — Enter the date (month, day, year) when the billable activity occurred.

Time In — Enter the time when the billable activity started.

Time Out — Enter the time when the billable activity ended.

Name of Service Provider — The printed name of the service provider who provided the service event for on-site or off-site individualized skills and socialization.

Service Provider Signature — At least one service provider who provided the service event for on-site or off-site individualized skills and socialization must sign the form. If more than two service events occur in a calendar day, the service provider must complete a new Form 8615.

Initial all areas in which you assisted the person — Initial the box that corresponds to activities provided by the service provider. The services initialed must justify amount of time spent providing services. A minimum of one activity must be marked for a billable service claim to have occurred.

Community Locations Visited and Special Events or Occurrences — This field is required to identify the location(s) for off-site individualized skills and socialization and may be used to document special events or occurrences. If providing written documentation, enter the date on which the billable activity occurred and the staff initials.

ISS Service Delivery Logs -Update